1Division of Laboratory Medicine, Hiroshima University Hospital, 2Division of Physiological Function, Department of Clinical Practice and Support, Hiroshima University Hospital, 3Department of Gastroenterology and Metabolism, Hiroshima University Hospital, 4Department of Anatomical Pathology, Hiroshima University Hospital
We report a case of hepatic angiosarcoma. An 80-year-old man with impaired liver function was admitted to our hospital for detailed examination. Contrast-enhanced computed tomography (CECT) revealed a tumor lesion, which was 40 mm in diameter at segment 7 of the liver. Abdominal ultrasonography (US) showed a hyperechoic mass with an inhomogeneous and slightly unclear margin. Contrast-enhanced ultrasonography (CEUS) showed sparse irregular peripheral nodular enhancement on the arterial phase, and partial centripetal filling on the portal phase. The mass was slightly hypoenhanced 10 minutes later on the post vascular phase, but the internal nodular heterogeneous enhancement persisted. The enhancement pattern was similar to that of a typical hepatic hemangioma, but we suspected a hepatic angiosarcoma. Compared to plain CT performed for evaluation of another organ 3 months previously, CECT showed a rapidly growing mass in the same region of the liver with lymph node metastasis of the left gastric artery. We performed ultrasound-guided biopsy, and the lesion was pathologically diagnosed as hepatic angiosarcoma.